11754 SW GAARDE STREET f
11754 SW CAARDE STREET
CITY OF TIGARD►
DEVELOPMENT SERVICES F:P I G 1.1\11---F-R T.NG OFERM I I-
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 PF.FM T"r 0. . . . . . . s ENG98-0030
PRIM. VqRMI T ENG98-0030
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`:i I E P 0 D R 1-1'9'f�. . . : 11. 754 9W GAPIRDE 5 F PAfR(.;EA-.: 2i1 10FAP-01 74,10
d iSDT 1)1 S I ON. . . . : ZONING: R---7
OCK. . . . . . .. . . . : LLT. . . . . . . . . . . . . JURISDICTUIN: 'F10
Rmi,r rypL-,. cjm, PUBLIC Imp,[(,) 0L.44NT. (L.IN Ff ) VALUE
A?EDWENT DfATEs GRAD/EROS
,'-3URANGE S7 RFE1
Ph RF"ORMANGE S(Ahl HE.W
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Pol HWAY b
Al-t- UPAER
o-rAL . . . . . . . . .
m,-z;r%k 5 ,. STREET OPF.NIW?; TO INUALL A RKIC HAIRLINE SANITARY SEWER An
'!!JRtAW.r.9 THEREWITH.
NI)a FURMAN t y p c, Amount by 110 t ED r pc-pt
154 B. W. L-44-114Di.- 510. J.'-,
iinRf) OR
Phone #:
Htbfy.:. INUI.
Hilt.-I.. EI.Vb. 7 1 p- 10 In I..
CARD OR 9?P?3 -6E-16i
F-,S9-34-53
s 101*1 9;:WF*R-- - "41-K--J-, I
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�61:1-1--,A�--- I-N a 13RT) SUBURADF.
Issued Ry- f+[:1.4"1 1. 8 [114PICB
T WS--0ROCK
Yo otp a rk.) I.J.' 'VE1. COURSE
1;jty of WF(4RJNh rL)(JR.-.E
1,312-15 S. W. Hall. Blvd. -z*Ahl. S EWF..H - rRAF=F 1K P517 CON*;
1""GORD, ffi,eqcm 97PP-3 M. H. R. ("'. 0. 110NI JP1FP%1 F ION
Phone #4 639-4171 T 17-IF I S. I'R 1)
- -N :7 113141 ING
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t.iP I I I ON,
46319-41 71. (off ire) R.F P R ;;(IDD CONJUI.Jpb,
DR(I I NAUF
10-,ECIAL- CONDITIONS:
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G"31IFF'S SETTIC', INCO
A /U(*":-:
Name—,'
nate
Address 04 ?t� <7 Phone—
City Initial
On Acct.
State Zip Code
Price Amount
NOT RESPONSIBLE FOR LANDSCAPING
A service charge of 1.5%per month will be charged on all past due accounts.
Tots 1:
Not responsible for attorney's fees,
Approval
Bye .�
Customer Slgnature
Tank-Yo u P.O. BOX 1244. - Canby, OR 97013
(503) 263-2087 or (503) 632-6138 CCl3ft 70548
-� __.
CITY OF TIGARD
DEVELOPMENT SERVICES V1l._.LJMRTNG PERMIT
-
13125 SW Hall Blvd.. Tigard,OR 97223(603)639-4171 F',-RM.[ r #. . . . . .. . : PLM'390010DATE issurm: o1./iq/9. 9
F`nRCF-l.-: L291 IOSA01700
SITE PDDRFSS. . : 117,514 SW GAORD17 ST
SIJBD T V I S I FIN. . . . znNI NG- R-7
DI-Ocl,.. . . . . . . . . . LOT. . . . . . .. . . . . . . .
JJJRISDTCTI('.)N- TI(J
CLASS OF- WORK. NEW GARDAGE Dmir.OSAL.S. : rn MOP T.L.E HOME SPACES.
TYrs (IF' USE. . . . SF' WASHING MACH. . . . . . : 0 BACKFLOW PRFVNTRS. .
O(X,'LJPANCY CRF. . : R.3 r.L.00P DRAINS. . . . . . .. 121 TRAPS. . . . . . . . . . .
sinPIES. . . . . . . . . 0 0
rIYTL1REr3 WATER HEATERS. . . . . CATCH BASINS. . . . . . .
l..A1JNDRY TRAYS,, . . . , " 121 G)F RAIN DRAIhIS. . . . .
S I N K S. . . . . . . . . L.)R I lq; E.. .
0 GRFASF TRAPS. .
1 -AI)AT(3R 1 0 T I i E:R r--I X T,J R E G. . , . : 0 . . . . .
TLJB/SHOWERS. . . : 0 SEWER LINE (ft) . . . 360
WATER CLOSETS, : 0 WATER I.-INr ,ft ) . 0
DISHWASHERS. . . . : vi
QATN DRAIN (ft ) . 0
Ti s tq 1 1. t i on of 0 feet_pt of sewer
�I
d ra lot i t o n 1( t o he p,I in ppd, Fill
and inspec-tpci (it., r,p
Mnvp
A d I I i t i 0 TI 8 IT, Trq prer•,mit r-cq it i tpd for .1ct
.Ia I
tri the house by Ijc,pn�eri -)I,
tmbi ny t:7 ti ri t-r j4 r-
nt,)nPr-,.- ------ F E E S
LTt\iDA r'l.JRMAN y 1:? c3111 i,t by date
t1754 SW OAArtyq� PRMT s 1.05. 00 DEB 01 /19/99 99—;31.2P69
T T BARD OR 97 ';"it
51 P rT ji!!5- DES 01, 11 ,3199 9,9 3 1 j,_,,in F
,.)tJN 01.1r.773T CONST PLICTTON INIC
19640 sw sni._Ds WAY
WELT LINN OR 97068
Phone #: 638--73,20 0. 25 TOTAL
R
RF0.0TRr`D I NSPF('T I rlN�;
This permit is issued subject to the regulations rontained in the Srwrr, I tit-,fiec-t 1 or,
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mi. r. IT)Spprt icirl
Applicable laws, All work will be done in accordance withTr)yp exi st ing/ca
approved plans. This permit will ewpire if work is not started Pitiol Ttisliprt jot,
within 180 days of issuance, or if work is Suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in BAR 952--WJ-9110 through LIAR 95% 0N01 ANBA. You may
obtain copies Of these rules or direct questions to (KOC by calling
S S 1.1 e11 f, _,r mittr a Si gnat�qi,p
-
+'+.4' 1-++++++4,4-++ ++. fA 4 ++++-+4.4++++-1...1 44.4-++++4 +--4 4.++ ++. ,..{..1.{. .}.+...r.+.+++++++• 1.4-+++
r 1 r
d,-Ay
CITY OF TIGARD Plumbing Permit Application Plan CheCklr-
13"25 SW HALL BLVD. Commercial and Residential Recd By I �-
TIGARD, OR 97223 DateRec'd /- l
(503) 639-4171 Date to P.E.
Print or Type Date to DST
-
Incomplete or illegible applications will not ba accepted Permit e LFf 99-c6
n Related SWR#��[<% 9-C�✓�
Called --
Name of Development/Project FIXTURES (individual) u -� OTY PRICE AMT
Job �>
.2lp-de' , t 1.' Sink - -- - - --
�}'�1 tr L-fit � 9.00
Address StreetAddr ss 1 Suite Lavatory 9.00
rc - l I Tub or Ti,')/Shower Corr,b 9.00
Bldg t I City/State Zip) �,� Shower Only 9.00
/
Name Water Closet 9.00
Dishwasher 9.00
Owner Melling Address
,/ Suite Garbage Disposal 9.00
\
C'lid 4 kSk Washing Machine - 9.00
City/State ZI I Phone Floor Drain/Floor Sink 2" 9.00
rill 7 6t -1 - -- -
---- -- a r 3" - - 9.00
4t")--I vl ! 4,. _ 9 Go
Occupant Mailing AddrF.5 Suite Water Heater O conversion O like kind 9.00
G S o G _ Gas I Ing requires a separate mechanical permit.
City/Slate Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Name -
c -x -Other Fixtures(Specify) 900
Contractor
MailingAddress Suite 9.00
r✓
G R _ 9.00
Prior to permit Cit /State Z ip� Phone Sewer-1 st 100' 30.00
issuance,a copyint) Q Ic-W
Sewer-each additional 100' 25.00
of all licenses are Oregon Const.Cont.Board LIc.# Exp.nate 2 'z
required If Water Service-1 at 100' 30.00
expired In COT Plumbing Lic.A Exp.Date Water Service-each additional 200' 25.00
database ' Storm&Rain Drain•1st 100' 30.00
Name I-&,,,rr/ Storm&Rain Drain-each additional 100' 25.00
Architect Mobile Home Space 25.00
Or Melling Address Suite Commercial Back Flow Prevention Device or Anti- 25.90
Zr, 3w 147,1/ Pollution Device
Engineer 7City/State Zip Phone Residential Backflow Prevention Device' 15.00
WLL 3 (p '- 'j (Irrigation liming devices requ're a separate
Describe work to bed restricted energy permit.)
New X Repair O Replace with like kind: Yes O No O Any Trap or Waste Not Connected to a Fixture 900
Residential'O Commercial O Catch Basin 9.00
Additional description of work: Insp.of Existing Plumbing 40.00
SA n i to r Sev►�'Y w��tiecl7rl i o /u' per/hr
Specially Requested Inspections 40.00
J 1 u;1 Irl yJ�✓ �)I(Gi rC11C t, _ Per/hr
single family dwelling 30.00
Are you capping,moving or replacing any fixtures? Rein Drain, -
Yes 0 No 1W Grease Traps 900
if yes,see back of form to indicate work performed by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram Is required NOuantltyTotal is >9
WORK COULD RESULT IN INCREASED SEWER FEES._ *SUBTOTAL n
I hereby acknowledge that I have read this application,that the Information
given Is correct,that I am the owner or authorized agent of the owner,and 5%SURCHARGE r�
that pians submitted are In compliance with Oregon State Laws.
Sign ture of Owner/Agel(rt ,) Date **PLAN REVIEW 25%OF SUBTOI AL
j/ I/'/,) Required only M fixture qty total is>9
77 7 TOTAL f�a
Contact Person Name Phone
C �,,36.73`0 •Minimum permit fee is$25+5%surcharge.except Residential Backflow
G+ �J Prevention Device,which is$15+5%surcharge
(� I -All New Commercial Buildings require plans with Isometric or riser diagram
/ ( and plan review
'WitsWhumapp doc 7219il �.-� V �� (.�-�`/, �`-•-.
_ N 2 ✓
PLEASE COMPLETE:
Fixture Type — Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink -- - — --- - ----
- --
Lavatory —
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain/Floor Sink 2" _
411
Water Heater
Laundry Room Tray —
Urinal
Other Fixtures (Specify)—
COMMENTS REGARDING ABOVE:
I WMAPIUMWPAac MM
CITY OF TIGARD
DEVELOPMENT SERVICES S,F-WFR CONINFCTInN
,
13125 SW Hall Blvd., Tigard,OR 97223(503)639.4' r•71 F'F RM T T' #1P•. 0!1 T T. „
DATF ISSUED: 01 /1.9/`39
PARCEL- 2531 117113A---01700
rTF ADDRESS. . . : 11754 SW GA(IRDE ST
IJiar)T V 13 1 ON. . . . ZONING: R 7
i+! OC;K. . . . . . . . . . LOT. . . . . . . . . . . . . . ,JLIRISUIC:TT.ON: TICS
TF'NANT NA MF, . . . . :FURMnN, I... I NDP
U',.IA NO. „ . . r"T. X TURF UN T TS. . . : 0
CLASS OF WORI!. . . :NEW DWFL._L.I NG LINT T S. . : t
TYPE:" OF USE'.. . ,. . . :SF NO. OF BU I i..D I NGS: 111
T NGT(31_.L. TYPE. . . . :L_7 PSWR T h117,FRV SURFACE': 0 s f
Rem,:Arks : Tnstallati.on of 1'iC0 feet of sewer• i rrle. Sept i�' tank to be i31.ImPerd, f I
ed
and insperteri or rpmovc,(1. Acicliti.onz,l pll_ImhiTig permit req,..1i.r,eci fol- ar-tl_Ial
clannrc.^'t i nT) t r, tllr F7oli sr. by I i c rTineri pl tlmlli rig reTni;rar_ t lir,.,
nlgner•: -•--• _-...._ ....._.__-_....._.._...._.._. -_.....-...._----_..._._...____ -- _.------ -._._.._._..._..---....__..__.._._. FE-ES —
I...TNDA F-LIRM(IN typra amol.Int 1-+v cl, l;,a rerpt //��/97
1. 1'7 ;4 SW GAARDE PRMT $ 2300. 00 DI"13 01/19/99 S9_.,a11.`,"6
TIGARD OR ':97._'24 TN!:)P $ 35.. 170 DF13 01 / 19/99 `39 -:312, E:',':9
Phonp #t:
C3011trartor: _...._____.__-_.__...__..._.__ ._ .. .._.__....__.__...._..._.__
SUN QAJF ST ('nl\IGTRIJC'T I OI\l INC
19(',/1V1 13W Dnl jip, WAY
WF!7')T I.. TNN nR 97060
Phnrrp ##: 6314- 732.0 t ,`.:,;s ;. 1710 T(IT01.
Rpy #. . : 132E3F)
_.. ._-- RFC,tIJTRF I► IN! FTE f-,TInN`,
This Applicant agrees to comply with all the rules and regulations
of the Unified Sewage Agency. The permit expires 180 days frog __.._._..._..........___.__._._._._.._.
the date issued. The tctal amount paid will be forfeited if the
permit expires, The Agency does not guarantee the arcuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distp,ice given. If not to located, the installer shall purchase
a "Tap end Side :,ewer" permit and the Agency will install a lateral.
ATTENTIrN: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are get forth in CAR
352-001-0810 through OAR 952-0001-8080. You may obtain copies of
these rules or gdestions to ODIC by calling 1583►246-19@7.
Issue _ by : �. � n ?4t' ,,L r r mit 1::ep Cil natl_Ire : //L 1T[ C"
+++++++•++ 1, 1.+ 1_+..4. 1-4 V4 F+•+-+ r..+-F+++•+•1 +++++++ }.}.}++++f•++•+•++++4-++-1-++•++-4++++++++++}+++•++4
Call 639 -41.713 by 7:00 p. m. for an ir-15per f: i.on t l,1, riovt t)rls i nes-, clay
+++ ++ ++++-++•+++++++++-1-+.+,4-.1-+4++++•+4-4•+•++++++++++•+++++++++++++++++++-++++++++++-+++-4-+-I